MEDICARE: ANTHONY DAVIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CHR.0008442	CO

General Provider Information

NPI Number	:	1710641196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY DAVIS

Provider Business Mailing Address
First Line	:	2785 N SPEER BLVD # LW02
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-4219
Country	:	US
Telephone Number	:	303-859-8310
Fax Number	:

Provider Business Practice Location Address
First Line	:	2785 N SPEER BLVD # LW02
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-4219
Country	:	US
Telephone Number	:	303-859-8310
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2021
Last Update Date	:	10/22/2021

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Directions to “ ANTHONY DAVIS ” Practice Location

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